During this period the pilot phase of the Strong Heart Family Study has been completed successfully with enrollment of 920 members of 31 extended 3-generation families. These individuals and approximately 2,900 additional members of the Strong Heart Study are undergoing assessment by carotid ultrasonography, non-invasive arterial pressure waveform recording and computerized electrocardiography, all of which are coordinated by CDMAS of the GCRC. Progress report and summary of findings: The most important new findings are: (1) American Indians have a higher prevalence of carotid atherosclerosis than White or Black Americans of the same age; (2) Diabetes causes arterial hypertrophy and atherosclerosis; (3) Prolongation of the Q-T interval of the electrocardiogram and ST segment depression measured by computerized techniques predict cardiovascular death independently of standard risk factors; (4) Left ventricular ejection fraction and other measures of ventricular function are lower in women than in men; (5) Left ventricular mass and aortic size are strongly heritable, independent of recognized stimuli to their growth; (6) Diabetes adversely affects left ventricular diastolic function, independently of all recognized risk factors.